Wilms tumor

Wilms tumor or nephroblastoma is a type of kidney tumor that attacks children aged 3 to 4 years, especially boys. This tumor usually attacks only one kidney, but does not exclude that the tumor can attack both kidneys of the child's body. Wilms tumor is a type of tumor that rarely occurs. However, this tumor is the most common kidney tumor in children compared to other types of tumors.

Causes of Wilms tumor

The cause of Wilms tumor is not yet known with certainty. However, several factors can increase the risk of contracting this disease in children, namely:

• Genetic factors. If a family member has a history of Wilms tumor, there is a higher risk that a child will also have a Wilms tumor.
• Congenital anomaly. Wilms tumors represent a high risk for babies or children with congenital abnormalities, such as:
• Aniridia, a condition characterized by the loss of part or all of the colored eye (iris).
• Hypospadias, which is a condition when the urinary tract hole in the penis is not where it should be.
• Cryptorchidism, a condition when the testes do not descend to the scrotum at birth.
• Hemihypertrophy, which is a condition when a part of the body is bigger than the rest of the body.
• Has several diseases. Several types of diseases can also put children at risk for Wilms tumors, although this disease is also rare. Among them:
• WAGR syndrome, a combination of symptoms of anemia, abnormalities in the genitals and urinary system, and mental retardation.
• Beckwith-Wiedemann syndrome, characterized by above average birth weight (> 4 kg) and abnormal growth.
• Denys-Drash syndrome, linking kidney disease and testicular abnormalities.

Symptoms of Wilms tumor
The main symptoms of Wilms tumor are pain and swelling of the stomach. However, Wilms tumors can also cause other symptoms, such as:

• fever
• Excessive fatigue and weakness
• Decreased appetite
• Nausea and vomiting
• constipation
• hard to breathe
• Increased blood pressure
• Hematuria or blood in the urine
• Unbalanced body growth

Wilms Tumor Diagnosis
In the first step of diagnosis, the doctor will review the patient's medical history and symptoms. Then, the doctor will do a physical examination to detect the presence of the tumor by pressing on the patient's stomach. To confirm the diagnosis, the doctor will advise the patient to undergo several additional tests, namely:

• Blood and urine tests to check the patient's kidney and liver function and general health.
• Imaging tests, to get a more detailed picture of the state of the body's organs, especially the kidneys, as well as to detect the spread of tumor cells. The types of imaging tests that can be performed are abdominal ultrasound, X-ray, CT and MRI.
• Biopsy, which involves taking tumor tissue samples for analysis and laboratory evaluation.

After the doctor confirms the diagnosis, he will determine the stage of the Wilms tumor where the child is suffering. There are 5 Wilms tumor stages that indicate the severity of the tumor, namely:

• Stage 1 - Tumors are only in the kidney and can be cured by surgery.
• Step 2 - The tumor has spread to the tissue around the kidney, including blood vessels. At this stage, surgery remains the ideal choice for treating Wilms tumors.
• Step 3 - The tumor has spread and started to reach other stomach organs or lymph nodes.
• Step 4 - The tumor has spread to other organs located far from the kidney, such as the lungs, bones or brain.
• Stage 5 - The tumor has invaded both kidneys.

Wilms tumor treatment

The doctor will determine treatment steps for Wilms tumors based on age, tumor severity and overall health of the child. There are three main treatment methods, namely:

• Surgical removal of the kidney (nephrectomy), which consists of a partial, complete ablation procedure or both kidneys with tumors. Patients whose kidneys have both been removed will undergo dialysis (hemodialysis) for the rest of their lives or will undergo a kidney transplant if they get a donor kidney. Surgery is the most common treatment method for patients with Wilms tumors.
• Chemotherapy. This procedure is done if the tumor size is large enough or if surgery is unable to remove all cancer cells. Chemotherapy will destroy the remaining cancer cells. Sometimes chemotherapy is also done before surgery to reduce tumor size.
• Radiation therapy (radiotherapy) is a therapeutic treatment that uses high-frequency radiation beams directed at the parts of the body that are infected by cancer cells. Radiation therapy can also be an option for patients with tumor conditions that have spread to other organs in the body.

The doctor will give medicine to patients to control pain, nausea and prevent infection. Patients are also advised to conduct periodic examinations to determine whether cancer cells reappear and to evaluate the function of new or remaining kidney.
Wilms tumor complications

Wilms tumor complications occur when the tumor has spread and attacks other organs in the body, such as the lungs, lymph nodes, liver, bones or brain. Some of the complications that Wilms tumor patients may experience are:

• Renal insufficiency, especially if tumors are present in both kidneys.
• Heart failure.
• Decreased growth and development of children, especially in size.

Wilms tumor prevention
Wilms tumor cannot be prevented. However, if the baby is born with certain birth defects or has a Wilms tumor-related syndrome, it is advisable to carry out routine ultrasound at least every 3-4 months until the baby is born. children 8 years old so that tumors can be detected and treatment steps can be taken at an early stage. .

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